House File 766 H-1158 Amend House File 766 as follows: 1 1. Page 79, after line 35 by inserting: 2 < DIVISION ___ 3 DISTRIBUTION OF FEDERAL FUNDS —— RESTRICTIONS —— ABORTION 4 Sec. ___. DISTRIBUTION OF FEDERAL PUBLIC HEALTH SERVICES 5 ACT FUNDS FOR FAMILY PLANNING. 6 1. The department of public health shall annually apply 7 to the United States department of health and human services 8 for grant funding under Tit. X of the federal Public Health 9 Services Act, 42 U.S.C. §300 et seq. The department shall 10 distribute all grant funding received to applicants in the 11 following order of priority: 12 a. Public entities that provide family planning services 13 including state, county, or local community health clinics, 14 federally qualified health centers, and community action 15 organizations. 16 b. Nonpublic entities that, in addition to family planning 17 services, provide required primary health services as described 18 in 42 U.S.C. §254b(b)(1)(A). 19 c. Nonpublic entities that provide family planning 20 services but do not provide required primary health services as 21 described in 42 U.S.C. §254b(b)(1)(A). 22 2. Distribution of funds under this section shall be made in 23 a manner that continues access to family planning services. 24 3. a. (1) Distribution of funds under this section shall 25 not be made to any entity that performs abortions, promotes 26 abortions, maintains or operates a facility where abortions are 27 performed or promoted, contracts or subcontracts with an entity 28 that performs or promotes abortions, becomes or continues to be 29 an affiliate of any entity that performs or promotes abortions, 30 or regularly makes referrals to an entity that provides or 31 promotes abortions or maintains or operates a facility where 32 abortions are performed. However, the prohibition specified 33 in this subparagraph (1) shall not be interpreted to include 34 a nonpublic entity that is a distinct location of a nonprofit 35 -1- HF766.1284 (7) 88 pf/rh 1/ 6 #1.

health care delivery system, if the distinct location provides 1 family planning services but does not perform abortions 2 or maintain or operate as a facility where abortions are 3 performed. 4 (2) The department of public health shall adopt rules 5 pursuant to chapter 17A to require that as a condition of 6 eligibility as an applicant under this section, each distinct 7 location of a nonprofit health care delivery system shall be 8 assigned a distinct provider identification number and complete 9 an attestation that abortions are not performed at the distinct 10 location. 11 b. For the purposes of this section, “nonprofit health 12 care delivery system” means an Iowa nonprofit corporation 13 that controls, directly or indirectly, a regional health 14 care network consisting of hospital facilities and various 15 ambulatory and clinic locations that provide a range of 16 primary, secondary, and tertiary inpatient, outpatient, and 17 physician services. 18 c. For the purposes of this section, “abortion” does not 19 include any of the following: 20 (1) The treatment of a woman for a physical disorder, 21 physical injury, or physical illness, including a 22 life-endangering physical condition caused by or arising from 23 the pregnancy itself, that would, as certified by a physician, 24 place the woman in danger of death. 25 (2) The treatment of a woman for a spontaneous abortion, 26 commonly known as a miscarriage, when not all of the products 27 of human conception are expelled. 28 4. Funds distributed in accordance with this section shall 29 not be used for direct or indirect costs, including but not 30 limited to administrative costs or expenses, overhead, employee 31 salaries, rent, and telephone and other utility costs, related 32 to providing or promoting abortions as specified in this 33 section. 34 5. The department of public health shall submit a report to 35 -2- HF766.1284 (7) 88 pf/rh 2/ 6

the governor and the general assembly, annually by January 1, 1 listing any entities that received funds pursuant to subsection 2 1, paragraph “c”, and the amount and type of funds received by 3 such entities during the preceding calendar year. The report 4 shall provide a detailed explanation of how the department 5 determined that distribution of funds to such an entity, 6 instead of to an entity described in subsection 1, paragraph 7 “a” or “b”, was necessary to prevent severe limitation or 8 elimination of access to family planning services in the region 9 of the state where the entity is located. 10 Sec. ___. ADMINISTRATION OF PERSONAL RESPONSIBILITY 11 EDUCATION PROGRAM AND SEXUAL RISK AVOIDANCE EDUCATION GRANT 12 PROGRAM FUNDS. 13 1. Any contract entered into on or after July 1, 2019, by 14 the department of public health to administer the personal 15 responsibility education program as specified in 42 U.S.C. 16 §713 or to administer the sexual risk avoidance education 17 grant program authorized pursuant to section 510 of Tit. 18 V of the federal Social Security Act, 42 U.S.C. §710, as 19 amended by section 50502 of the federal Bipartisan Budget 20 Act of 2018, Pub. L. No. 115-123, and as further amended by 21 division S, Title VII, section 701 of the federal Consolidated 22 Appropriations Act of 2018, Pub. L. No. 115-141, shall exclude 23 as an eligible applicant, any applicant entity that performs 24 abortions, promotes abortions, maintains or operates a 25 facility where abortions are performed or promoted, contracts 26 or subcontracts with an entity that performs or promotes 27 abortions, becomes or continues to be an affiliate of any 28 entity that performs or promotes abortions, or regularly makes 29 referrals to an entity that provides or promotes abortions or 30 maintains or operates a facility where abortions are performed. 31 However, the prohibition specified in this section shall not be 32 interpreted to include a nonpublic entity that is a distinct 33 location of a nonprofit health care delivery system, if the 34 distinct location provides personal responsibility education 35 -3- HF766.1284 (7) 88 pf/rh 3/ 6

program or sexual risk avoidance education grant program 1 services but does not perform abortions or maintain or operate 2 as a facility where abortions are performed. 3 2. The department of public health shall adopt rules 4 pursuant to chapter 17A to require that as a condition of 5 eligibility as an applicant, grantee, grantee contractor, 6 or grantee subcontractor under the personal responsibility 7 education program or sexual risk avoidance education grant 8 program, each distinct location of a nonprofit health care 9 delivery system shall be assigned a distinct identification 10 number and complete an attestation that abortions are not 11 performed at the distinct location. 12 3. For the purposes of this section, “nonprofit health 13 care delivery system” means an Iowa nonprofit corporation 14 that controls, directly or indirectly, a regional health 15 care network consisting of hospital facilities and various 16 ambulatory and clinic locations that provide a range of 17 primary, secondary, and tertiary inpatient, outpatient, and 18 physician services. 19 4. For the purposes of this section, “abortion” does not 20 include any of the following: 21 a. The treatment of a woman for a physical disorder, 22 physical injury, or physical illness, including a 23 life-endangering physical condition caused by or arising from 24 the pregnancy itself, that would, as certified by a physician, 25 place the woman in danger of death. 26 b. The treatment of a woman for a spontaneous abortion, 27 commonly known as a miscarriage, when not all of the products 28 of human conception are expelled. 29 Sec. ___. AWARD OF COMMUNITY ADOLESCENT PREGNANCY 30 PREVENTION AND SERVICES PROGRAM GRANT FUNDS. 31 1. Any contract entered into on or after July 1, 2019, 32 by the department of human services to award a community 33 adolescent pregnancy prevention and services program grant 34 using federal temporary assistance for needy families block 35 -4- HF766.1284 (7) 88 pf/rh 4/ 6

grant funds appropriated to the department shall exclude 1 from eligibility any applicant, grantee, grantee contractor, 2 or grantee subcontractor that performs abortions, promotes 3 abortions, maintains or operates a facility where abortions are 4 performed or promoted, contracts or subcontracts with an entity 5 that performs or promotes abortions, becomes or continues to be 6 an affiliate of any entity that performs or promotes abortions, 7 or regularly makes referrals to an entity that provides or 8 promotes abortions or maintains or operates a facility where 9 abortions are performed. 10 2. The eligibility exclusion specified in subsection 1 11 shall not be interpreted to include a nonpublic entity that 12 is a distinct location of a nonprofit health care delivery 13 system, if the distinct location provides community adolescent 14 pregnancy prevention program services but does not perform 15 abortions or maintain or operate as a facility where abortions 16 are performed. 17 3. The department of human services shall adopt rules 18 pursuant to chapter 17A to require that as a condition of 19 eligibility as an applicant, grantee, grantee contractor, 20 or grantee subcontractor under the adolescent pregnancy 21 prevention and services program, each distinct location of 22 a nonprofit health care delivery system shall be assigned a 23 distinct identification number and complete an attestation that 24 abortions are not performed at the distinct location. 25 4. For the purposes of this section, “nonprofit health 26 care delivery system” means an Iowa nonprofit corporation 27 that controls, directly or indirectly, a regional health 28 care network consisting of hospital facilities and various 29 ambulatory and clinic locations that provide a range of 30 primary, secondary, and tertiary inpatient, outpatient, and 31 physician services. 32 5. For the purposes of this section, “abortion” does not 33 include any of the following: 34 a. The treatment of a woman for a physical disorder, 35 -5- HF766.1284 (7) 88 pf/rh 5/ 6

physical injury, or physical illness, including a 1 life-endangering physical condition caused by or arising from 2 the pregnancy itself, that would, as certified by a physician, 3 place the woman in danger of death. 4 b. The treatment of a woman for a spontaneous abortion, 5 commonly known as a miscarriage, when not all of the products 6 of human conception are expelled. 7 Sec. ___. SEVERABILITY. If any provision of this division 8 of this Act or the application of this division of this Act to 9 any person or circumstances is held invalid, the invalidity 10 shall not affect other provisions or applications of this 11 division of this Act which can be given effect without the 12 invalid provisions or application and, to this end, the 13 provisions of this division of this Act are severable. 14 Sec. ___. EFFECTIVE DATE. This division of this Act, being 15 deemed of immediate importance, takes effect upon enactment. > 16 ______________________________ SALMON of Black Hawk -6- HF766.1284 (7) 88 pf/rh 6/ 6